Re: Perioperative Events and Complications in Minimally Invasive Live Donor Nephrectomy: A Systematic Review and Meta-Analysis

Editorial Comment: Since the first clinical description in 1995, laparoscopic live donor nephrectomy has become a standard approach for donor nephrectomy. There are multiple variants of the technique, including pure laparoscopic, hand assisted, retroperitoneoscopic and robot-assisted. The authors performed a systematic review and meta-analysis evaluating early complications. They reviewed hundreds of studies using specified criteria. Their review contains the outcomes of more than 32,000 patients. Despite many limitations of their work (there is a whole section of the article devoted to this issue), this report is a nice summary of experience with this operation. Overall the authors identify a complication rate of 7.3% and mortality rate of 0.01%. Comparisons were made between the various techniques. No dramatic outcome differences were noted between methods, but some subtleties were identified. The authors note that complications occurring at 1% or more include bleeding, conversion to open procedure, infection related complication (including wound infection) and ileus. This is an interesting compendium, attesting to the safety of laparoscopic live donor nephrectomy. David A. Goldfarb, MD